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Boris Johnson is set to spark a political row this week by pressing ahead with the Health and Social Care bill. The bill gives ministers greater control of the NHS and there have been warnings that the move will see ministers blamed for delays in treatment and the closure of local hospital units.
Javid is expected to lay the bill before parliament on Tuesday after the prime minister overruled his plea to delay its introduction until the autumn. Johnson has told Matt Hancock’s successor to press ahead with the legislation despite Javid’s concern that it will prove “controversial” and involves “significant areas of contention” which have yet to be resolved.
Conservative MPs are becoming increasingly anxious that the bill could make people question Tory handling of the NHS and prove a gift to Labour, which last week called for the bill to be scrapped. The health secretary’s new powers would enable him to abolish NHS arm’s-length bodies and intervene much earlier in deciding if an A&E or maternity unit deemed unsafe had to be shut.
Though health service chiefs are thought to be broadly supportive of the bill, the Guardian report that hospital bosses have voiced serious concern about the government’s plan to hand Javid such big new “powers of direction”. The NHS Confederation and NHS Providers, the two groups which represent health service trusts, both warned that this could allow ministers to wield undue influence over the NHS and reduce its independence. While MPs are thought to be worried about the bill making the Government responsible for long NHS waiting times and doing little to alleviate those waiting times and chronic understaffing.
The bill, which only relates to the NHS in England, does include plans to reduce some privatisation by removing the duty on the NHS to put care contracts out to tender. However, the British Medical Association warned that it could lead to the new integrated care systems (ICSs) offering large contracts to private firms without any tendering process.
The passage of the bill comes as Javid and the board of NHS England must also decide who will succeed Sir Simon Stevens as the next leader of the NHS. Ministers want his replacement to have a much lower profile and not cause trouble by regularly lobbying in public for the NHS to be given more money and the government to radically reform social care. Javid, Johnson and the chancellor, Rishi Sunak, must also decide imminently whether to increase the government’s 1% pay offer to NHS staff.
Source: The Guardian, 4 July 2021
See also: HSJ - Number 10 insists ICSs will go ahead next year
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The HSJ has learned that Sir Jim Mackey and Baroness Dido Harding are no longer in the running to become the new chief executive of NHS England. According to sources, former NHS Improvement CEO Mackey was not among the names shortlisted to replace Sir Simon Stevens, whilst two national newspapers have revealed that Sajid Javid has ‘’vetoed’’ Baroness Harding. HSJ understands that KPMG senior partner Mark Britnell, NHSE deputy CEO Amanda Pritchard, and Leeds City Council chief executive Tom Riordan remain in the running for the job.
Source: HSJ, 4 July 2021
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Matthew Taylor, chief executive of the NHS Confederation, and Richard Murray, chief executive of the King’s Fund, argue that Sajid Javid should push ahead with the Health and Social Care bill.
Taylor and Murray argue that Javid should move forward with the Bill because it will benefit the NHS. They suggest that there is a broad health service consensus on the bill as, they argue, most of the bill is what the NHS itself has asked for – a switch from competition to collaboration as its guiding light. For Taylor and Murray, the bill is about enabling the NHS to work more effectively with local government, the voluntary sector, and other partners to improve the health of local communities, including by tackling longstanding health inequalities.
Moreover, Taylor and Murray argue that the Bill will not introduce much that is wholly new but is instead a ‘’legislative capstone’’ for the changes to the NHS envisaged by Sir Simon Stevens which are already underway. They argue that delaying the bill now risks even more disruption by preventing the NHS from continuing the preparations it has already begun and could cause an exodus of staff who feel uncertain about their job security. They argue that a delay risks undermining the momentum toward collaboration that the pandemic has necessitated.
However, Taylor and Murray do note parts of the bill were not requested by the NHS, such as expanding the health secretary’s powers to both direct NHS England and to intervene in operational issues. They suggest that these clauses could simply be removed from the bill or changed through amendments. This would address opposing criticisms made by Labour, say Taylor and Murray.
Source: The Times, 5 July 2021
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The decision of one public health leader in New Zealand to quit smoking after 45 years is inspiring other New Zealanders to give up tobacco. Ned Tapa, who is kaitakitaki-cultural advisor/educator of Whanganui’s District Health Board, says that his decision to quit has inspired his whānau, the Māori-language word for extended family or community of related families living together in the same area, to also give up smoking.
Tapa explains that he decided to quit when one day "I had run out of smokes, so then I decided 'that's it - no more'." He says that since quitting he can feel the difference in his breathing and recovery rate from sports. Tapa says that since his decision three of his immediate whanau have now been smoke-free for more than three months with ''no desire’’ to return to smoking with other whānau members ''seriously looking at their smoking habits and starting the journey to being smoke-free."
Source: New Zealand Herald, 3 July
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Becky Freeman and Christina Watts, University of Sydney, argue that the increased depiction of vaping on film is not a problem in the same way that previous depictions of smoking on screen were, but that appropriate regulation should be implemented nonetheless.
Freeman and Watts note that the growing popularity of e-cigarettes in modern life have seen these products appear more and more in popular movies and TV shows. For instance, the 2010 film The Tourist, the second season of popular Netflix series House of Cards, and the film adaptation of Cymbeline all depict their characters using e-cigarettes.
This might lead us into thinking that the vaping industry is repeating the successful tobacco marketing strategy of the past, glamourising e-cigarettes on screen. Freeman and Watts say that we should however resist this conclusion as there are plenty of other examples of modern depictions of vaping on screen which are notably different to previous portrayals of smoking insofar as they do not glamourise vaping.
Freeman and Watts point to the critically acclaimed show Mare of Easttown which shows its character vaping in scenes of high stress and to escape conflict situations, suggesting her vaping is depicted as an addiction. Similarly, in the film I Care a Lot the main character vapes having previously run a failed vape business. Importantly, there is no evidence that vaping in either of these productions is sponsored by the vaping industry, unlike in the past with smoking on screen and the tobacco industry.
This being said, Freeman and Watts argue that policy proposals aimed at further reducing smoking on screen could still be helpful for vaping depictions. These proposals include adult ratings on content that depicts use, certifying that no payoffs were received for vaping depictions, and not making vaping brands identifiable on screen.
Source: The Conversation, 4 July
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